Breast self-examination

• routine breast self examination has not been shown to be an effective method of screening for breast cancer; there is currently no evidence to support the view that it should be a primary screening technique (1,2)
  • based on studies examined in a systematic review (2), regular breast self examination does not reduce breast cancer mortality but increases the number of women who have biopsies with benign results
• the vast majority of breast cancers (>90%) are found by women themselves - therefore there is a need to optimise the chances of women finding cancerous breast lump and the prompt reporting of any changes from normal
• earlier presentation increases the proportion of breast malignancies that can be treated with breast conservation
• breast awareness is a concept where a woman is encouraged to become familiar with the texture of their normal breast tissue and how it changes at different times of the month and with age; women should become aware of any changes from the normal state and report changes without delay
• breast awareness is a change from the regular, ritualistic process of breast self examination; to one in which breast examination is built into women's life experience

The Chief Medical Officer previously advised (3) that whilst the effectiveness of breast self-examination in reducing mortality from breast cancer has never been consistently demonstrated, 'breast awareness' should be promoted.

Reference:

1. Austoker J. Cancer Prevention in Primary Care: Screening and self examination for breast cancer. BMJ 1994; 309: 168-74.
2. Kosters JP, Gotzsche PC. Regular self-examination or clinical examination for early detection of breast cancer. Cochrane Database Syst Rev 2003;(2):CD003373.
3. Department of Health. Breast awareness. Department of Health. November 1991; Professional Letter: PL/CMO (91), 15.